Journal of Yeungnam Medical Science

Case report

Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia: Min Kyu Kang, Hee Jung Kwon, Min Cheol Kim; Yeungnam Univ J Med. 2020;37(3):246-249. Published online April 10, 2020; DOI: https://doi.org/10.12701/yujm.2020.00094

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Abstract PDF: Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

Case Report

Tracheal pleomorphic adenoma with coexisting pulmonary tuberculoma: Jehun Kim, Chul-Ho Oak, Tae-Won Jang, Mann-Hong Jung; Yeungnam Univ J Med. 2018;35(1):114-120. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.114

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Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

Citations

Citations to this article as recorded by

Pleomorphic adenoma of the trachea: A case report
Mayu Inomata, Shoei Kuroki, Nobuyuki Oguri, Yuichiro Sato, Fumiya Kawano, Ryo Maeda
International Journal of Surgery Case Reports.2023; 109: 108499. CrossRef
Pleomorphic adenoma of the trachea: A case report and review of the literature
Qian-Nuan Liao, Ze-Kui Fang, Shu-Bing Chen, Hui-Zhen Fan, Li-Chang Chen, Xi-Ping Wu, Xi He, Hua-Peng Yu
World Journal of Clinical Cases.2020; 8(23): 6021. CrossRef
Pleomorphic adenoma of the trachea: A case report and review of the literature
Qian-Nuan Liao, Ze-Kui Fang, Shu-Bing Chen, Hui-Zhen Fan, Li-Chang Chen, Xi-Ping Wu, Xi He, Hua-Peng Yu
World Journal of Clinical Cases.2020; 8(23): 6026. CrossRef
Obstructive tracheal neoplasm
Badreeddine Alami, Saïd Boujraf, Mohamed Smahi, Mounia Serraj, Moulay Youssef Alaoui Lamrani, Meryem Boubbou, Mustapha Maaroufi
Formosan Journal of Surgery.2019; 52(3): 92. CrossRef

Original Article

High levels of carcinoembryonic antigen and smoking might be markers of colorectal adenoma in Korean males aged 40-49 years.: In Cheol Yoon, Jeong Hyeon Cho, Heejin Choi, Young Hoon Choi, Kyu Min Lim, Sung Hwa Choi, Jae Ho Han, Hyeon Ju Jeong, Hong Sub Lee; Yeungnam Univ J Med. 2016;33(1):13-20. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.13

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Abstract PDF: BACKGROUND
Prevalence of adenoma in males aged 40-49 years in Korea was higher than expected. The aim of this study was to investigate the prevalence and risk factors of colorectal adenoma in males aged 40-49 years. METHODS: Total 1,902 asymptomatic subjects with a mean age of 47.9±6.7 years, who underwent a screening colonoscopy in a health promotion center of Myongji Hospital from 2010 to 2013 were enrolled in this study. We conducted a case-control study to determine the risk factors for adenoma. The subjects were classified into two groups (adenoma vs. controls). To validate the diagnostic value of carcinoembryonic antigen (CEA) for adenoma, area under the receiver operating characteristic curve (AUROC) was calculated. RESULTS: At least one colorectal adenoma was identified in 385 subjects (20.2%). Among these 385 subjects, 372 subjects were found to have a non-advanced adenoma, 13 subjects had an invasive adenoma. One subject had cancer. Male sex, age, smoking, metabolic syndrome, and elevated CEA level were significantly associated with a colorectal adenoma in univariate analysis. However, metabolic syndrome was not significant in multivariate analysis. In the male group, the AUROC of CEA for colorectal adenoma was 0.600 (0.543 to 0.656) in non-smokers under 50 years of age, and 0.615 (0.540 to 0.690) in smokers under 50 years of age. CONCLUSION: Male sex, smoking, and high levels of CEA seem to be associated with colorectal adenoma. High levels of CEA and smoking may be diagnostic markers for any colorectal adenoma in Korean males aged 40-49 years.

Case Reports

A Case of Duodenal Brunner's Gland Adenoma Treated by Endoscopic Rescetion.: Sung Joon Kim, Min Geun Gu, Jun Suk Park, Kyeong Ok Kim, Si Hyung Lee, Tae Nyeun Kim, Jun Hyuk Choi; Yeungnam Univ J Med. 2011;28(1):84-89. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.84

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Abstract PDF

Brunneroma, also known as Brunner's gland adenoma or harmatoma, is a very rare benign tumor of the duodenum, which is usually asymptomatic, and is discovered incidentally during endoscopic exam. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. We report on a case of a large Brunner's gland adenoma in a 54-year-old man, which was successfully removed by endoscopic resection without complications, such as bleeding or perforation. Microscopically, it was composed entirely of variable Brunner's gland.

Citations

Citations to this article as recorded by

Solitary schwannoma of the ascending colon
Myeong Su Chu, Hyun Mo Kang, Hyeong Ju Sun, Dong Min Kim, Hyong Jong Kwak
Yeungnam University Journal of Medicine.2016; 33(1): 37. CrossRef

A Case of Functionary Cystic Parathyroid Adenoma with Papillary Thyroid Carcinoma.: Woo Jin Chang, Hyun Hee Jung, Sang Hyen Park, Se Hoon Sohn, Ji Sung Yoon, Hyoung Woo Lee, Kyu Chang Won, In Ho Cho; Yeungnam Univ J Med. 2010;27(2):139-145. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.139

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Abstract PDF: Cystic parathyroid adenoma is one of rare causes of hyperparathyroidism, and tends to cause increased serum level of parathyroid hormone, alkaline phosphate and serum calcium level similar to when compared to those of solid adenoma.

Original Article

Use of Sonography in the Differential Diagnosis between Phylloides Tumor and Giant Fibroadenoma.: Jong Oh Choi, Jae Woon Kim, Won Kyu Park, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1996;13(2):295-301. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.295

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Abstract PDF: Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic find;.ngs of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Ye mgnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.

Review

A study of PCNA Expression in Gastric Adenoma and Adenocarcinoma.: Mi Jin Kim, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1995;12(1):1-9. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.1

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Abstract PDF: A monoclonal antibody to PCNA, which can be used on routinely processed tissue, was applied to 25 cases of gastric adenomas and 64 cases of gastric adenocarcinomas in order to diffentiate adenoma and adenocarcinoma and also to evaluate the prognostic value in adenocarcinoma. The results were summerized as follows: The PCNA labelling index was 29.14+/-12.77% in control, 44.09+/-17.11% in adenoma and 80.15+/-10. 69 in adenocarcinoma, resulting in significant increase in adenocarcinoma compared to adenoma. In adenocarcinoma, no significant correlation was observed between PCNA labelling index and histologic grade, and there -was increased tendency of PCNA labelling index in proportion to depth of invasion without statistical significance. The PCNA index was significantly increased in advanced adenocarcinoma compared to early gastric carcinoma, and also in positive nodal metastasis group than in negative group. From above results, the PCNA stain will be able to provide a helpful method for the differential diagnosis between gastric adenoma and adenocarcinoma, and could be a useful prognostic factor in adenocarcinoma if other factors are considered together.

Original Article

Histopathological study of gastric adenoma.: Dong Sug Kim, Hae Joo Nam, Won Hee Choi, Tae Sook Lee, Moon Kwan Chung; Yeungnam Univ J Med. 1991;8(2):76-83. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.76

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Abstract PDF: A total of 53 gastric adenomas from endoscopically biopsied gastric mucosa were examined histopathologically. The average age at the time of endoscopic biopsy was 59 years, and gastric adenomas were found to be more frequent in the aged, particularly above the age of 50. The majority of adenomas occurred at the antrum. Concerning the shape of the adenomas, Yamada type II was more frequent (55%). All adenomas were accompanied by varying degree of intestinal metaplasia, and this findings suggest that gastric adenoma develops from intestinal metaplasia. In adenomas with severe atypia (grade III), endocrine cells (argyrophil and argentaffin cells) were markedly decreased or absent. Gastric adenocarcinomas coexistent with adenoma were seen in 5 (9.4%) out of 53 cases, and were more frequent in male than female patients (sex ratio, 4:1) and the average age was 61.4 years. It is suggested that there is a necessity of thorough follow-up study for definitive correlation between gastric adenoma and adenocarcinoma.

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